Khemchand N Moorani, Mukesh Raj.
Spectrum of infections in children with newl diagnosed primary nephrotic syndrome.
Pak J Med Res Jan ;51(1):10-4.

Background: Children with primary nephrotic syndrome are more susceptible to bacterial infections which may trigger disease or relapse or cause steroid resistance in these children. Objectives: To determine the spectrum of infections in children with newly diagnosed primary nephrotic syndrome. Study type, settings and duration: A Retrospective case record analysis was carried out in the department of Pediatric Nephrology, National institute of child health (NICH), Karachi from January 2007 -December 2008. Subjects and Methods: Patients with newly diagnosed primary nephrotic syndrome who presented with various bacterial infections were included in the study. Data for age, gender, type of infection were computed on SPSS -10 and analyzed using descriptive statistics. Results: A total of 355 children with renal problems were registered during the study period, out of which 155 were newly diagnosed primary nephrotic syndrome. Sixty (38.7%) children had one or more infections at the time of admission. There were 34(56.7%) boys and 26(43.3%) girls whose ages ranged from 1-15 years (mean 5.22 years). Majority of patients (36) were below 5 years of age and 24(40%) were above 5 years. Acute respiratory tract infection and urinary tract infections were the most common infections found in 28(46.6%) and 15(25%) cases respectively. Common clinical presentation was edema (100%) followed by fever in 52(86.6%), cough in 28(46.6%), urinary symptoms in 12(20%), vomiting in 8(13%) and diarrhea in 7(11.6%).One patient presented with convulsions. Conclusions: For children presenting with primary nephrotic syndrome, acute respiratory infection and urinary tract infections should be kept as the commonest reason for infection. Policy message: Training of paediatricians is required in diagnosing these chronic illnesses.

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